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Cardiovascular Research 2003 59(4):980-987; doi:10.1016/S0008-6363(03)00520-0
© 2003 by European Society of Cardiology
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Copyright © 2003, European Society of Cardiology

Differential localisation of the renin–angiotensin system in de-novo lesions and in-stent restenotic lesions in in-vivo human coronary arteries

Lodewijk J Wagenaara, Ad J van Bovena, Allard C van der Walb, Giovanni Amorosoa, René A Tioa, Chris M van der Loosb, Anton E Beckerb and Wiek H van Gilsta,*

aDepartment of Cardiology, Thoraxcenter, University Hospital of Groningen, Groningen, The Netherlands
bDepartment of Cardiovascular Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

w.h.van.gilst{at}med.rug.nl

* Corresponding author. Department of Clinical Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Tel.: +31-50-363-2811; fax: +31-50-363-2812.

Objective: Different components of the renin–angiotensin system (RAS) have been demonstrated in atherosclerotic plaques. However, the involvement of the RAS in in-stent restenosis is not clear. We studied the differential immunolocalisation of angiotensin converting enzyme (ACE) and the angiotensin II type 1 (AT1) receptor in de-novo stenotic lesions and in-stent restenotic lesions in human coronary arteries. Methods: Using a pullback atherectomy catheter, biopsies from de-novo coronary lesions (n=19) and in-stent restenotic lesions (n=19) were obtained. The biopsies were immunostained for vascular smooth muscle cells (VSMCs), macrophages, ACE and the AT1 receptor. Results: In biopsies from de-novo stenotic lesions ACE-positive macrophages were more numerous than in in-stent restenotic lesions (P=0.002). Moreover, in the latter lesions, ACE-positive macrophages decreased when the time interval of stent implantation was longer. On the other hand, in-stent restenotic lesions contained predominantly young VSMCs, which abundantly expressed AT1 receptors. Conclusions: Lesional ACE expression is not a prominent feature of in-stent restenotic lesions. In contrast, AT1 receptors are abundantly expressed on young VSMCs. In de-novo lesions ACE and AT1 receptors were found on macrophages and VSMCs, which were present in all specimens.

KEYWORDS Renin angiotensin system; Receptors; Coronary disease; Stents; Restenosis


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